Please see a Urologist if you are experiencing the following symptoms:

Any aspect of Male Infertility – a small percent of male factor infertility is because of testicular cancer. This is often missed by primary care doctors and when referred to an IVF fertility doctor.

Blood in the Urine (Hematuria) – whether visible (Gross Hematuria or only seen under a microscope (Microscopic Hematuria) is not normal and can be an early warning sign of a bladder or kidney cancer. The work-up is basic, including urine tests, an x-ray such as a CT Scan and a look inside a bladder with a fiber optic scope (cystoscopy). Waiting to see if the blood will go away is not smart. Blood one time is enough to see a Urologist.

An elevated PSA or change in PSA – the PSA remains one of the most sensitive indicators of prostate cancer of all tests in medicine. Any elevation raises concerns so must be evaluated. Simply telling you to go away and let’s see how high it goes or how fast it climbs, even if it is still within “normal” levels, the change may suggest cancer. Any change in significance should be evaluated.

An abnormal prostate exam – Any abnormality, firmness, small nodules, or irregularities – may be from a prostate cancer and so must be seen by a urologist. Any change from prior exam must be seen. This is why it is so important that all men over the age of 40 to 45 get a yearly exam, ideally by the same doctor. As with potentially serious problems, if detected early the sure is high.

Any abnormality of the Kidney found on x-ray – It must be assumed that these are kidney cancers until proven otherwise. Do not let anyone biopsy a kidney mass unless you have seen aurologist. Biopsies of kidney mass can actually cause more harm, and often do not provide the information desired.

A testicular mass or persistent pain – Because of the rare chances of having an underlying testicular cancer, any masses, firmness or nodul
es of the testicle must be seen by a urologist. This also includes men with testicular pain that does not resolve within a week or two. If
caught early, testicular cancer is one of the most curable cancers in humans.

Prostate cancer is a huge concern for men and the best way to avoid it is to prevent it. It is recommended that men with an average risk of prostate cancer makes choices that benefit their overall health such as choosing a healthy diet, maintaining a healthy weight and exercising regularly.

Some men have an increased risk of prostate cancer. For those who have high risk of prostate cancer, there may be other options for risk reduction, such as medications. If you think you have a high risk of prostate cancer, reach out to an AUS Physician to know your options.

Calcium stones –Most Kidney stones are calcium stones, usually in the form of calcium oxalate. Oxalate is a naturally occurring substance found in food. Some fruits and vegetables, as well as nuts and chocolate, have high oxalate levels. Your liver also produces oxalate. Dietary factors, high doses of vitamin D, intestinal bypass surgery and severe metabolic disorders can increase the concentration of calcium or oxalate in urine. Calcium stones may also occure in the form of a calcium phosphate.

Struvite stones – Struvite stones form in response to an infection, such as urinary tract infection. These stones can grow quickly and become quite large, sometimes with few symptoms or little warning.

Uric Acid stones – Uric acid stones can form in people who don’t drink enough fluids or who lose too much fluid, those who eat high - protein diet, and those who have gout. Certain genetic factors.

Cystine stones – These stones form in people with hereditary disorder that causes the kidneys to excrete too much of a certain amino acid called cystinuria.

Prostate Specific Antigen Test (PSA) – This kind of test measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer.

The higher the PSA level in the blood, the more likely a prostate problem is present. Many factors can affect PSA levels. Because many factors can affect PSA levels, your AUS physician is the best person to interpret your PSA test results.

A Vasectomy is a safe and effective method of permanent birth control for men. This is often done as an outpatient surgery. Before your operation, your urologist will instruct you on what you need to bring and ask you to make sure that your genital area is clean. Your doctor may suggest that you bring someone to drive you home after the surgery.

For billing purposes, it would also be best to contact your insurance provider to make sure that this is a covered benefit.

Please bring any forms that needs to be filled out (you may download the forms under “Patient Resources” in our website), insurance cards, valid government issued identification cards, list of present medications and any records needed for your appointment.

The best way to avoid urological problems is to maintain good overall health habits such as exercising regularly, maintaining a healthy weight, avoiding substances that will remove water from the body (like tobacco, excessive alcohol, and caffeine). AUS is an advocate for Men’s Health. To know more about AUS’Men’s Health programs, pleasecontact your AUS physician for more information.

Diagnostic FAQ's

If your Doctor wants the CT scan no contrast, you can eat and drink before the test. If your Doctor wants the scan with contrast, do not eat 3 hours before your scheduled time, and do not drink 1 hour before your test.

IMRT FAQ's

In recent years, cancer treatment has transformed from a one shot treats all approach, to patient specific treatment. We are at the forefront of that trend. Over the past several years, we have incorporated the analysis of genes known to promote the growth of prostate cancer into our treatment protocols. We continue to expand the use of such tests as they become available. Patients can now be better informed and have greater understanding as to why certain treatments are offered. Often, such treatment will differ from a patient’s expectation and from others with a similar diagnosis.

Cancer patients whose disease has spread to bones often have severe pain that causes a significant decline in their quality of life. Unfortunately, the appearance of bone metastases also heralds a path of limited life expectancy. These patients are often treated with strong pain medication, such as morphine, which is an effective pain reliever, but can be associated with troublesome side effects. The pain from bone metastases may also be treated with focal external beam radiation therapy directed to one or two sites. However, when there are multiple bones involved, radiation in the form of a radioactive venous injection is often prescribed. In the past, such treatment, while effective, was limited in the frequency of use, because of damage to healthy blood cells. Thus, not only could they not be administered with much frequency, but the low blood counts placed the patient at risk of infection, anemia, and bleeding. Other cancer treatment, such as chemotherapy, could not be given to such patients, because of these agents own toxicity to blood cells.

In the past year, a new injectable radioactive treatment for bone metastases (Ra-223/Xofigo) was given FDA approval. Xofigo is administered every four weeks for six total doses. The radiation exposure to surrounding tissue, including blood cells, is more limited than previous such treatment. Xofigo is a safer treatment than previously existed. Each dose is administered in the Cancer Center, and the patient is sent home with minimum risk to other people. Not only does treatment with Xofigo reduce pain, but it has been shown through studies to prolong life.

IGRT is a refinement of the advanced radiation therapy technique known as Intensity Modulated Radiation therapy or IMRT. This is a sophisticated manner of “painting” doses of radiation around critical body structures so that maximum dose is delivered to the organ of interest and minimal dose is received by sensitive nearby organs or tissue. This is particularly important in the treatment of prostate cancer, which requires the use of a high dose of radiation to obtain cure. The prostate is surrounded by critical structures; the bladder attached to the upper most part of the prostate and the rectum that hugs the back edge. IGRT provides the most safe and effective method available for treatment of this disease.

When cancer spreads from a primary site to other organs, including bones, it is said to have metastasized. Such involvement of these other areas can often cause pain or interfere with function. A relatively short ourse of external beam radiation therapy, ten to fifteen treatments, can often result in significant relief of pain and improvement of function.

Requests for a second opinion may be requested through your physician or by calling the laboratory. If your specimen was sent to Associated Urological Specialists Lab, phone: 708-532-9922.

AUS Lab will ship materials to the physician/institution (e.g. Mayo Clinic, University of Chicago, Northwestern University) of your choice.

Michael Herzog

"Dr. Herzog is an outstanding and highly-skilled doctor. I have been a patient of Dr. Herzog's since 2008 and I feel that he goes above and beyond for his patients.His excellent bedside manner and incredible medical knowledge truly make me feel that he is the best. He patiently answers all my questions and I feel confident knowing that I am in his care."
-EK

James Sylora (1)

Dr. James Sylora

"James Sylora is a great doctor, second only to his father, Herme, who I started with several years ago. He is a great person, easy to talk to. Most doctors today have their heads buried in computers. Dr. Jim actually takes the time to look at me when he talks to me. He has a great sense of humor." - ES

George Sreckovic (1)

Dr. George Sreckovic

"I have been a patient of Dr. Sreckovic since 2007. During that time I have experienced and observed excellent medical knowledge and care accompanied with sensitive bedside manner." - LG

Mark Lyon (1)

Dr. Mark Lyon

"Dr. Lyon is lovable, caring, and an understanding person. If I were on a basketball team, I would like him to be my manager. I am blessed to have him in my life, taking care of me." - AF

Steven Pierpaoli (1)

Dr. Steven Pierpaoli

"Dr. Pierpaoli is very efficient. I am very happy with my medical care, and the doctor and office staff treat me very well." - RB